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A coronary angioplasty is a procedure used to treat both blockages (occlusions) and constrictions in the arteries that supply blood to the heart muscles.After giving a local anaesthetic, the specialist will insert a very narrow tube called a catheter into either the radial artery (in your wrist) or the femoral artery (at the top of your leg). At the end of the catheter there is a small balloon. Using X-Ray type imaging, the balloon can be positioned inside the blocked or damaged artery. A saline solution is used to inflate the balloon to open up the blockage (stenosis) to help restore normal blood flow. It is often necessary to place a small mesh tube (stent) inside the damaged artery, as a final step, to avoid further narrowing.
Stents can be used in various parts of the body vasculature, from the coronaries (the heart) to the peripheral arteries (abdomen, kidneys, legs or feet). Their purpose is to support the arterial walls and to maintain the optimal arterial diameter. Stents are supplied mounted on a balloon catheter, in a sterile pack. The doctor places the stent in the artery by inflating the balloon. The stent expands to fit the diameter of your artery and the balloon is then deflated and removed.
Bare-Metal Stents (BMS) also called conventional stents made from stainless steel or cobalt-chromium alloy. Their usage decreased in recent years because they have a tendency to become blocked again due to the artificial overstimulation of the body’s natural healing process leading to the artery re-narrowing. Drug-Eluting Stents (DES) are coated with a type of drug normally used to treat cancer.
This drug, while avoiding cell proliferation, has the effect of interfering with the artery healing natural process. With this type of stent it is necessary to take antiplatelet drugs for a prolonged period of time. There is a significant risk associated with stopping this medication too early.
Bio Active Stents (BAS) differ from Bare Metal Stents and Drug Eluting Stents because they use a special metal alloy coating called Titanium Nitride Oxide.
This coating is specifically formulated to make the stent more bio compatible allowing the natural healing process of the artery, reducing therefore the need to take powerful antiplatelet drugs for a long period of time. The different features of these three types of stent make them suitable for different patients’ indications. It is the responsibility of a specialist, after he has made a diagnosis, to select the most appropriate type of stent.
When the artery diameter returns to its optimal size, blood flow can return to normal, and the heart is said to be re-vascularised. The stent will also help to maintain the optimal diameter of the artery to prevent further coronary heart disease. A blocked coronary artery can lead to a heart attack (myocardial infarction) and damage (necrosis) of a part of the heart muscle. The use of a stent allows an optimal result during the interventional procedure, a reduction of the residual stenosis and minimises the risk of re-occlusion of the treated artery.
The stent serves to improve the blood supply to the heart muscle and should improve the quality of lives of patients. After angioplasty with stenting, the patient can resume normal daily activities very quickly. It is usually recommended to avoid violent physical activities and exertion at very low temperatures or high altitudes for a few weeks (typically 3 to 4).
The antiplatelet drug is used to thin the blood, in order to avoid a clot forming that could re-block the treated artery. The duration of treatment may vary between 1 to 12 months and can last much longer depending on the patient and the type of stent used (with or without drug). This decision remains the responsibility of a specialist.
Patients are usually able to return to work just a few days after an angioplasty, even if several diseased vessels were treated, whereas an absence following bypass surgery will normally last a few weeks.
This information is for reference and education only and cannot replace the information provided by a doctor.
